Provider Demographics
NPI:1871361188
Name:HORTON, MACIA ELIZABETH
Entity type:Individual
Prefix:MISS
First Name:MACIA
Middle Name:ELIZABETH
Last Name:HORTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MARSH AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2214
Mailing Address - Country:US
Mailing Address - Phone:508-317-8986
Mailing Address - Fax:
Practice Address - Street 1:216 W BOYLSTON ST STE 200
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1788
Practice Address - Country:US
Practice Address - Phone:508-981-4204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician